© Borgis - New Medicine 1/2011, s. 30-34
*Márk Oravecz1, Haixue Kuang2, Judit Mészáros3
Education and licensing of traditional Chinese doctors in China
1PhD student, Doctoral School, Semmelweis University, Budapest, Hungary
2Director, Heilongjiang University of Chinese Medicine, Harbin, P.R. of China
3Dean, College of Health Sciences, Semmelweis University, Budapest, Hungary
Traditional Chinese medicine (TCM) is an integral part of Chinese health care. Traditional Chinese doctors and practitioners of modern medicine are subject to the same set of regulations regarding education, licensing and continuous education. Due to the constantly growing interest in TCM and especially its education and licensing procedures, this article describes the systems of education, licensing and continuous education currently used in the People’s Republic of China.
The education of traditional Chinese doctors in China is modernized and institutionalized. Its two mainstays are university education and continuous education. Traditional structures of education, the strong emphasis on clinical practice and person-to-person teaching are also integrated into this system. The education and practice of TCM in China do not differ structurally from those of modern medicine. Students of TCM are required to learn modern medicine and are examined in modern medicine during their studies and upon the physicians’ qualification exam. TCM doctors use the methods of modern medicine in conjunction with TCM during their everyday work. Traditional Chinese doctors are an essential part of the Chinese health-care system and there is an increasing international demand for TCM professionals trained according to this model.
Traditional Chinese medicine
Traditional Chinese medicine has a set of characteristics which define its everyday practice in clinical work and education as well, and with which the reader should be acquainted. The two most unique characteristics of TCM are “holism” (zheng ti guan nian) and “treatment defined by pattern identification” (bian zheng lun zhi). The term “holism” denotes an axiom according to which the complex processes of the human body entail constant innumerable interactions, thus necessitating the usage of functional models, through which the momentary condition of the human organism may be described in its entirety instead of emphasizing the examination of minute structural details. Treatment based on “pattern identification” is the conclusion of this axiom: the patterns, categories and states arrived at through the usage of such functional models become the definitive bases of all applied therapy. It is thus possible that within the nomenclature of TCM a given disease as defined by modern medicine can be classified into further sub-groups with different principles of therapy and different modes of treatment for each sub-group.
Besides these two fundamental theoretical principles TCM also has the following characteristics: it has unique therapeutic procedures (acupuncture, Chinese manual therapy, individualized multi-componential herbal therapy, etc.), it places great emphasis on prevention, and due to the past two millennia of state patronage it also has a very rich corpus of literature, which constitutes an integral part of a continual, living tradition and which is a great pool of currently relevant clinical experience.
The role of traditional Chinese medicine in China
Before the modern period traditional Chinese medicine was the official medical system of China. As early as 1500 years ago, systematic education and research were conducted in the imperial courts of China and this institutionality continued until the end of the imperial period (1911). From the second half of the 19th century modern medicine became more and more prevalent in China.
Proclamation of the People’s Republic of China (1949) saw the introduction of the current system, in which traditional Chinese medicine is on an equal level with modern medicine (1). There are hospitals specializing in Chinese medicine and at the same time numerous modern medicine type hospitals feature TCM wards. There are departments in TCM hospitals where modern medicine is used almost exclusively, like in the intensive care units. Universities also share this structure. In China – as far as medical universities go – there are TCM universities and modern medical universities, the latter much like the ones we know in the western world. Subjects of western medicine are taught within the curricula of TCM universities. Most universities dedicated to modern medicine also feature TCM departments. Thus the two different medical systems have a symbiotic relationship within one integral health-care system. Traditional Chinese Medicine provides 10-20% of health care services in China (2). TCM related research has been a great driving force behind the development of Chinese health care and international scientific relations.
Traditional Chinese Medicine in China’s system of education
Traditional Chinese medicine has two models of education. One is the traditional master-apprentice model, which used to be the main method of teaching in historic times. The other is university tuition, which has become the main mode of TCM education.
Chinese university education is divided into three levels: bachelor’s, master’s and PhD levels. Undergraduate education for traditional Chinese doctors takes 5 years and contains about 5000 hours. This may be followed by graduate and post-graduate studies, of 3 years duration each. Undergraduate TCM education is divided into majors, according to fields of specialization. The most important majors are: traditional Chinese medicine major (with emphasis on training clinicians using herbal therapy), acupuncture-manual therapy major, traditional Chinese pharmacology major, etc. There also exist TCM vocational schools offering 3-year academic programs.
In China there are currently 23 independent institutions of TCM higher education: 12 universities and 13 colleges. Besides these, 58 other universities have TCM colleges, departments or programs. 45 TCM vocational schools and TCM training in 184 other vocational schools complement these universities. Currently 270 000 students study Chinese medicine in China, 150 000 of whom are undergraduate university students and 23 000 graduate or post-graduate students (3).
Education of traditional Chinese doctors in China
The main principles of TCM education according to the Chinese Ministry of Education and the State Administration of TCM as stated in the Basic requirements of undergraduate TCM education (2008) are as follows (3). The most basic aim of traditional Chinese medical education is the training of TCM professionals who have a systematic knowledge of the theories of Chinese medicine, who have specialized proficiency in TCM’s diagnostic and therapeutic methods, who are in command of a complex and reasonably structured system of knowledge, who are versatile, innovative and practical and can perform TCM therapeutic, educational and research duties.
The requirements for “traditional Chinese medicine” majors and “acupuncture-manual therapy” majors are similar, with slight differences. In the 5-year undergraduate program the general requirements for both majors are that the student systematically master TCM’s fundamental theories, basic therapeutic and diagnostic techniques, that the student master a part of modern medicine’s basic knowledge and a part of modern medicine’s therapeutic and diagnostic methods, that the student become familiar with TCM clinical thinking, that the student obtain proficiency in clinical skills, that the student be able to apply the methods of both TCM and modern medicine in the treatment and prevention of common diseases, that the student learn to obtain knowledge independently and be able to participate in certain research tasks. Such students, upon successfully passing the final exams, receive the bachelor of medicine degree. For “traditional Chinese medicine” majors the emphasis is placed on mastering the clinical usage of herbal therapy, especially in diseases of internal medicine, but also including emergency medicine. For “acupuncture-manual therapy” majors greater emphasis is placed on acupuncture and manual therapy, especially their applications in the fields of neurology, orthopedics and rehabilitation.
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1. Central Committee of the Chinese Communist Party, State Council: Guanyu weisheng gaige yu fazhan de jueding (Decree on health-care reform and development) 1997. http://www.moh.gov.cn/publicfiles/business/htmlfiles/wsb/pM30115/200804/18540.htm (in Chinese). 2. State Administration of TCM, Public Administration College of Beijing University: National yearbook of TCM statistics. 2008. http://www.satcm.gov.cn/96/%C8%AB%B9%FA%D6%D0%D2%BD%D2%A9%CD%B3%BC%C6%D5%AA%B1%E0/main.htm. (in Chinese). 3. Ministry of Education of P. R. of China, State Administration of TCM: Gaodeng xuexiao benke jiaoyu zhongyixue zhuanye shezhi jiben yaoqiu (Basic requirements of TCM undergraduate education). 2008. http://126.96.36.199/publicfiles/business/htmlfiles/moe/s3864/201010/xxgk_109607.html (in Chinese). 4. Central People’s Government of P. R. of China. Zhonghua renmin gongheguo zhiye yishi fa (Law on Licensed Doctors of the P. R. of China). 1999. http://www.gov.cn/banshi/2005-08/01/content_18970.htm (in Chinese) http://www.satcm.gov.cn/English2010/Policy/2010-10-06/151.html (in English). 5. State Administration of TCM. Zhongyiyao jixu jiaoyu guiding (TCM continuous education decree). 2006. http://law.baidu.com/pages/chinalawinfo/8/20/dc96dc7d1ad7743b4347b733d61e1d33_0.html (in Chinese)